#set($title = "退会手続き確認画面")
<!-- preHeader -->
#parse( "/WEB-INF/view/common/preHeader.vm" )
##<!-- JAVASCRIPT ここに記載-->
<script language="JavaScript" type="text/JavaScript">
function back(){
document.forms[0].action="#q('/user/withDraw/back/')";
document.forms[0].submit();
}
</script>
<body bgcolor="#B3C9E1" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0">
<center>
<!-- header -->
<table width="1024" cellspacing="0" cellpadding="0">
<tr>
<TD>#parse( "/WEB-INF/view/common/header.vm" )</TD>
</tr>
<tr>
<TD>
<table width="1024" border="0" cellspacing="0" cellpadding="0">
<tr>
<td width="25"><img src="/em/images/spacer.gif" width="25" height="1" border="0"></td>
<td width="1024" bgcolor="#FFFFFF">
<table width="100%" border="0" cellspacing="5" cellpadding="0">
<tr>
<td align="right" width="155" valign="top">#parse( "/WEB-INF/view/common/menu.vm" )</td>
<td align="left" width="10" background="/em/images/cts_bar.gif"><img src="/em/images/spacer.gif" border="0"></td>
<td align="center" valign="top">
##CONTENT START 各ページコンテンツ
<table width="780" border="0" cellspacing="0" cellpadding="0">
<tr>
<td class="ctsTitle">退会手続き</td>
</tr>
</table>
<!-- Contents Title Table End -->
<form action="/em/user/withDraw/withDrawRegist/" method="post">
#makeToken()
<BR>
<table width="740" border="0" cellspacing="0" cellpadding="0">
<tr>
<td width="5"><img src="/em/images/cts_cmt01.gif" width="5" height="23" border="0"></td>
<td width="730" class="attention">eモニ会員退会注意点</td>
<td width="5" align="right"><img src="/em/images/cts_cmt03.gif" width="5" height="23" border="0"></td>
</tr>
<tr>
<td background="/em/images/cts_cmt02_bg.gif"><img src="/em/images/spacer.gif" width="5" height="5" border="0"></td>
<td>eモニ会員を退会すると<font color="red">現在のポイントが全て失われてしまいます</font>
</td>
<td background="/em/images/cts_cmt03_bg.gif"><img src="/em/images/spacer.gif" width="5" height="5" border="0"></td>
</tr>
<tr>
<td><img src="/em/images/cts_cmt02.gif" width="5" height="5" border="0"></td>
<td background="/em/images/cts_cmt04_bg.gif"><img src="/em/images/spacer.gif" width="1" height="5" border="0"></td>
<td><img src="/em/images/cts_cmt04.gif" width="5" height="5" border="0"></td>
</tr>
</table>
<BR>
<table width="740" border="0" cellpadding="2" cellspacing="1" bgcolor="#004080">
<tr>
<td class="listmenu">配信退会を希望する理由</td>
</tr>
<tr>
<td class="listcts">
<!-- 配信退会理由 -->
#foreach( $str in $withDrawForm.withDrowReasonBoxes)##選択されてチェックボックス
#set($msgKey ="withDraw.checkBoxComment"+$str)
#if($velocityCount > 0)</BR>#end
$!text.get($msgKey) ##文言
<input type="hidden" name="withDrowReasonBoxes" value="$!str">
#end
##<input type="hidden" name="reasonMsg" value="$!withDrawForm.reasonMsg">
</td>
</tr>
<tr>
<td class="listmenu">今後の参考にさせていただきますのでよろしければいたらなかった点をお教えください</td>
</tr>
<tr>
<td class="listcts" align="left" >
<!-- <textarea name="reasonMsg" rows="7" cols="80" readonly> -->
$!tools.newLineToBr($!escape.html($!withDrawForm.reasonMsg))
<!-- </textarea> -->
</td>
</td>
</tr>
</table>
<table cellSpacing=10 cellPadding=0 border="0" width="100%">
<tr valign="bottom" >
<td colspan="2" align="center">
<input type="image" src="/em/images/taikai.gif" >
</td>
</tr>
</table>
</form>
##CONTENT END 各ページコンテンツ
<!-- Button Table Start 点線-->
<table width="780" border="0" cellspacing="5" cellpadding="0">
<tr>
<td background="/em/images/cts_btnbar.gif"><img src="/em/images/spacer.gif" width="1" height="10" border="0"></td>
</tr>
</table>
<table width="780" cellspacing="5" cellpadding="0" border="0">
<tr>
<td align="left">
<input type="image" border="0" align="absmiddle" src="/em/images/back_btn.gif" onclick="back();">
</td>
</tr>
</table>
<!-- Button Table End -->
</td>
</tr>
</table>
</td>
<td width="25"><img src="/em/images/spacer.gif" width="25" height="1" border="0"></td>
</tr>
</table>
</TD>
</tr>
<tr>
<TD>#parse( "/WEB-INF/view/common/footer.vm" )</TD>
</tr>
</table>
</center>
</body>
</html>